Erie County Executive Mark C. Poloncarz was joined today by Health Commissioner Dr. Gale Burstein and county Medicaid Inspector General Michael Szukala to respond to a recent report from the U.S. Senate Committee on Homeland Security and Government Affairs (“the Committee”) titled “Drugs for Dollars: How Medicaid Helps Fuel the Opioid Epidemic”. The report, released by the committee’s majority staff and the focus of a public hearing last month, suggests a link between the expansion of Medicaid under the Affordable Care Act and the nationwide opioid epidemic. In a letter sent to committee Chairman Senator Ron Johnson and all committee members, Poloncarz strongly refuted the premise of the committee’s report and presented evidence of a very different reality in Erie County and across the United States.

“The committee’s report was not factual, lacked specificity and used stereotypes and old information to manufacture an incorrect viewpoint. Simply put, we have seen no evidence that the expansion of Medicaid under the Affordable Care Act has fueled the opioid epidemic in Erie County, nor that Medicaid funding somehow fuels opioid addiction,” said Poloncarz. “To make these claims with no supporting evidence is wrong and muddies the water on a very important public health topic, so we felt a need to respond. In Erie County we are seeing the opposite of what is claimed in the committee report, with fewer prescriptions being written for opioids, more people having access to safe, evidence-based treatment, and heightened awareness of the dangers of fentanyl and other derivatives.”

Among other points, the Erie County letter notes that according to the Centers for Disease Control and Prevention (“CDC”) annual U.S. opioid prescribing rates increased from 2006-2010, prior to Medicaid’s expansion, and then decreased thereafter, including in the period following Medicaid’s expansion in 2014. Evidence obtained from current Erie County Medicaid data also supports the CDC’s findings of reductions in the number of opioid prescriptions being written annually, which declined markedly between 2010- 2015.

In Erie County from 2012 – 2015 the number one prescribed drug to Medicaid recipients was Hydrocodone-Acetaminophen, but that drug had fallen to number three by 2016 and to number five by 2017. To emphasize this point, the letter notes that although today there are 60,000 new enrollees in Medicaid as a result of its expansion compared to 2012, in 2017 there were 21,000 fewer prescriptions written for Hydrocodone-Acetaminophen. Chief among the reasons for this decline are New York’s I-STOP Program and more extensive education for medical professionals on the dangers of opioids.

The Erie County letter, which can be read here, also noted the increase in overdoses and deaths primarily related to the increasing use of fentanyl, and not attributable to the Medicaid expansion.

Poloncarz, a member of the National League of Cities/National Association of Counties Opioid Epidemic Drug Task Force, and Burstein, a nationally-noted expert on adolescent health, have toured New York State and the country sharing best practices with other local governments on how to respond to the opioid epidemic.